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Republic of India - Health, nutrition and population technical assistance to North East States (India).
Washington, D.C., World Bank, 2015 Jun 16. 9 p.The eight states in India’s North-East region are connected to the rest of the country by a narrow corridor and (until recently) were classified by the Indian government as special category states. This non-lending technical assistance (NLTA) was requested by the governments of Nagaland and Meghalaya, stemming from previous engagements with the World Bank Group - the state human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) program (supported by International Development Association (IDA) financing) in the case of Nagaland, and International Finance Corporation (IFC) advisory services for private sector involvement in government health insurance program and investment in medical education in the case of Meghalaya. Both state governments show commitment to improving health and nutrition services and outcomes and look to the World Bank to provide support. The state governments requested the Bank for technical assistance in specific areas for which other sources of support, particularly the national health mission, were not available, and improvements in which held the potential to leverage the effectiveness of existing government financing. The development objective of this activity is to support development of health system strategies, policies, and management systems in North East states.
WHO Collaborating Centre for Acquired Immunodeficiency Syndrome for the Eastern Mediterranean Regional Office, Faculty of Medicine, Kuwait University, Kuwait.
Medical Principles and Practice. 2014; 23 Suppl 1:47-51.In the early 1980s, the World Health Organization (WHO) designated the Virology Unit of the Faculty of Medicine, Health Sciences Centre, Kuwait University, Kuwait, a collaborating centre for AIDS for the Eastern Mediterranean Regional Office (EMRO), recognizing it to be in compliance with WHO guidelines. In this centre, research integral to the efforts of WHO to combat AIDS is conducted. In addition to annual workshops and symposia, the centre is constantly updating and renewing its facilities and capabilities in keeping with current and latest advances in virology. As an example of the activities of the centre, the HIV-1 RNA viral load in plasma samples of HIV-1 patients is determined by real-time PCR using the AmpliPrep TaqMan HIV-1 test v2.0. HIV-1 drug resistance is determined by sequencing the reverse transcriptase and protease regions on the HIV-1 pol gene, using the TRUGENE HIV-1 Genotyping Assay on the OpenGene(R) DNA Sequencing System. HIV-1 subtypes are determined by sequencing the reverse transcriptase and protease regions on the HIV-1 pol gene using the genotyping assays described above. A fundamental program of Kuwait's WHO AIDS collaboration centre is the national project on the surveillance of drug resistance in human deficiency virus in Kuwait, which illustrates how the centre and its activities in Kuwait can serve the EMRO region of WHO. (c) 2014 S. Karger AG, Basel.
Arlington, Virginia, Management Sciences for Health, Technologies for Primary Health Care [PRITECH], 1993 Jul. 20 p. (PRITECH Issues Paper No. 1; USAID Contract No. DPE-5969-A-00-7064-00)In the 1980s, Technologies for Primary Health Care [PRITECH] was involved in control of diarrheal diseases (CDD) projects that stressed oral rehydration therapy in many developing countries. In the mid 1980s, CDD training added diarrhea training units in teaching hospitals to train medical students in correct diarrhea case management. The World Health Organization (WHO) had developed a special case management course and supportive teaching materials for trainers and trainees that included hands-on training but not follow-up of the trainees. WHO and USAID worked with PRITECH to develop practical learning diarrhea-related activities and teaching materials for medical schools in developing countries. PRITECH introduced the activities from the medical education package in Pakistan, Indonesia, and the Philippines prior to 1988. It set up a pilot projects of the full package in the Philippines and Indonesia. WHO/CDD recommended revisions to the package in 1992. The major revision was adding a detailed workshop guide for national level workshops in introduce faculty to the new materials. The revised package was piloted in Vietnam, Nigeria, and India. In 1986, WHO and PRITECH/Sahel Office embarked on improving the diarrhea-related curriculum of nursing schools in the Sahel countries of Africa. Nursing teachers taking part in a workshop helped develop competency-based modules. These modules include an epidemiological overview and clinical concepts, treatment and prevention of diarrheal, disease, appendix (cholera), application of health education techniques to CDD programs, elements of a national program to combat diarrheal diseases, and a field training workbook and teacher's guide. 16 of 21 nursing schools in the Sahel are using them. The nursing curriculum provides for follow-up visits to CDD programs. The medical schools' teaching program needs to consider various issues, e.g., CDD medical education in an integrated context. Recommendations for donors concludes this summary report.
[Unpublished] 1989. Presented at the First International Symposium on No-Scalpel Vasectomy, Bangkok, Thailand, December 3-6, 1989. 10 p.The paper describes the introduction and use of the no-scalpel vasectomy in the United States. Vasectomy is popular in the U.S., with 336,000 of them performed in 1987 almost exclusively buy urologists, family practitioners, and surgeons. Receiving no government funding for the new procedure's introduction in the U.S., the Association for Voluntary Surgical Contraception (AVSC) turned to family planning clinics, Planned Parenthoods, and medical schools to reach experienced vasectomists interested in co-sponsoring orientation seminars for other doctors. Programs were held in 1988, in California, Massachusetts and New York, in which attendees were provided self-training packages, and asked to report their experiences with the new technique. Field reports were received from 25 physicians on 2,237 vasectomies, and included both positive and negative comments. Even though the technique is uncomplicated, physicians generally found the technique difficult to master with only teaching materials. Accordingly, the U.S. training model was modified to include a rubbermodel f the scrotal skin and underlying was with the training packet, visits to practitioners' offices by clinical instructors, a compressed training period of 1 day, and hands on training. A minimum of 6-9 cases is generally required to properly learn the technique. 3-4 training seminars will be conducted over the next year in different regions of the U.S. in addition to other efforts aimed at meeting demand for training from interested doctors. Care is taken in choosing instructors and participants, with interest especially strong in training of trainers. Of central concern to the AVSC is their ability to keep pace with growing demand for training, while ensuring 6-12 month follow-up and high-quality instruction and practice of the technique.
New policies and approaches of health education in primary health care in attaining the objectives of health for all/2000.
IN TOUCH 1991 Mar; 10(98):34-6.This overview of what the WHO Alma Ata Declaration is and how the objectives translate to policy in the structure of health education involves manpower development, professional level training, community involvement, mass media, and related research. Alma Ata identified health education as the first of 8 essential activities in primary health care (PHC). Policy failures in health education included the inability to live up to expectations, the targeting of programs to specific diseases, and to the inappropriate conceptualization of community participation as a process which can be centrally controlled. Other factors were the gap in understanding the relationship between socioeconomic development and health, weak national structure which provided inadequate demonstration of health education project results, the inability of health education to solve individual problems such as working conditions or environmental pollution, and the lack of multisectoral cooperation. In order to achieve the Alma Ata objectives health education must be an agent of social change. Primary health care (PHC) - health education, development of a patient's educational skills, needs to be incorporated into the formal curricula of medical and nursing programs, as well as informal training, planning, and practice among rural and agricultural developers, public health engineers, and educators. Health workers need training in use of appropriate technology and in bridging the gap between the community and existing health care systems. The mass media needs to emphasize basic health necessities, and the importance of health, and solutions to problems. Broad public participation including voluntary organizations is necessary to the multisectoral approach. Research needs to be disseminated to administrators.
In: The Graduate Education of Foreign Physicians in Public Health and Preventive Medicine. The Role of United States Teaching Institutions, edited by Wendy W. Steele and Sally F. Oesterling. Philadelphia, Pennsylvania, Educational Commission for Foreign Medical Graduates, . 26-28.The School of Public Health at Loma Linda University in California was founded in 1967, and as of December 1983 had graduated a total of 1764 students, 187 of whom were physicians. 28 countries and 45 foreign schools were represented in this enrollment. The experience at Loma Linda University is different from many others in that there has been little government sponsorship of foreign medical graduates. Of 89 foreign medical graduates, only 17 were sponsored by the US Agency for International Development or the WHO, and all 17 returned to their home countries where they are making significant contributions in Tanzania, Kenya, Thailand and Indonesia. In 1970, the Loma Linda University School of Public Health developed an evening program in which most of the course work was taught in Los Angeles 1 evening per week over a 2-year period. 10 health officers and a few others completed that program. Their success stimulated extending the program. In 1973 an experimental program teaching a general Master of Public Health (MPH) course to Canadians was initiated. In 1980, Loma Linda University also launched an extended program in the Central American-Caribbean area. In the context of a general program in public health and preventive medicine leading to a Master of Public Health Degree, the curriculum in international health seeks to prepare health workers who will be: trainers of trainers; cross-cultural communicators; managers and supervisors of primary health care services; and practitioners of the integrated approach to community development. Graduates are prepared to deal with sociocultural, environmental and economic barriers. Students not having a professional background in health are required to add an area of concentration to degree requirements. Areas of concentration include: tropical agriculture, environmental health, health administration, health promotion, maternal and child health, nutrition and quantitative methods/health planning. The goal of the International Health Department is to help people help themselves to better health. Loma Linda University has also been involved with schools in Asia, Africa, Latin America and recently in the Philippines. The preventive medicine residency program at Loma Linda is for the 2nd and 3rd years only at the present.
In: The Graduate Education of Foreign Physicians in Public Health and Preventive Medicine. The Role of United States Teaching Institutions, edited by Wendy W. Steele and Sally F. Oesterling. Philadelphia, Pennsylvania, Educational Commission for Foreign Medical Graduates, . 15-8.At a time when there is a growing interdependency among nations with regard to trade, resources and security, there is an increasing provincialism in the US. In such a climate it is difficult to generate support for international programs. Involvement on the part of medical schools has waned almost to the point of nonparticipation in international medical affairs, largely because of constraints on training and residency programs. Academic health centers have not been supported as a matter of policy. Leadership in international health in other parts of the world, diminished involvement in international health, current priorities and programs and a future prospectus are discussed. The WHO seems an unlikely source for necessary leadership in helping define future directions for education or new strategies in preventive medicine and public health in the developing world. Institutions in Europe have deteriorated and participation and leadership from them are unlikely. Few people today are interested in clinical tropical medicine. Another reason for waning academic activity in international health relates to the paucity of interest on the part of foundations. An important initiative was the development about 5 or 6 years ago of the WHO Tropical Disease Research Program. It now has a budget of about US $25 million and has attracted additional money from the US and from other countries. A gamut of prospects has resulted including a maria vaccine, a leprosy vaccine, a new drug for malaria. In the developing countries, there is a much larger base of basic competence than existed only 10 or 20 years ago, but these health workers need support if health goals are to be attained. Schools of public health should be as much professional schools as schools of medicine, and the practice of public health should be engaged in. The US Centers for Disease Control (CDC), in its global Epidemic Intelligence Service (EIS) program in Thailand and in Indonesia has pioneered admirable new approaches in practical training. Provision must be made for sufficient faculty to permit both professional practice and education in any school that offers public health education. The US has a vital and unique role to play in public health and preventive medicine.
In: White KL, Bullock PJ, ed. The health of populations: a report of two Rockefeller Foundation conferences, March and May 1979. New York, Rockefeller Foundation, Sept. 1980. 183-9.Reviews the interrelationships among epidemiology, medical education, and the planning, organization, and provision of health services. Epidemiology can be defined as the application of the scientific method and of biostatistical reasoning to the problems of health and disease in communities. Clinical epidemiology is of value in resolving problems arising from misallocation of manpower, facilities, technology, and service; adoption of unevaluated or inappropriate forms of medical intervention; overemphasis on laboratory and clinical medicine; and inadequate education and training in population-based medicine. Several reasons for the usual lack of success in teaching an epidemiological perspective have been identified. Some epidemiologists have recently made efforts to integrate the teaching of epidemiology with clinical medicine, and it is widely agreed that epidemiology and biostatistics should be included at all stages of the medical curriculum. Epidemiological scrutiny continues to be useful in elucidating the causes and risk factors of communicable and chronic disease, as well as iatrogenic disease and occupational health hazards. The importance of lifestyle and the interplay of behavioral, cultural, and economic factors with production of disease are attracting increasing attention. Increased use of epidemiological skills at all levels of medical care management and service will assist in rational allocation of health resources in developing countries, and possibly help them to resist overemphasis on advanced medical technology. Foundations can play an important role by supporting development of a consortium of clinical epidemiology units in both developing and developed countries.
In: White KL, Bullock PJ, ed. The health of populations: a report of two Rockefeller Foundation conferences, March and May 1979. New York, Rockefeller Foundation, Sept. 1980. 139-44.The background, planning process, and structure of the McMaster University-Sierra Leone project are described and its progress after 1 year of operation is assessed. It was agreed that the University of Sierra Leone would establish a Department of Community Health in Freetown and would not develop a medical school, while the Ministry of Health would develop a paramedical training school. The Ministry of Health's mandatory 2-year training program for physicians educated abroad would have cooperative links with the Department of Community Health. A senior coordinating committee directly responsible to the president of Sierra Leone would be responsible for subsequent project planning. Establishment of an eduational base in the Department of Community Health is intended to develop expertise in clinical epidemiology, biostatistics, and related areas. Community-based continuing education programs for potential users of the new disciplines at district and chiefdom levels are planned. Considerable progress has been made in the first year, but some anticipated problems have arisen and some necessary local support has wavered. Experience with this project suggests that the size of external aid must be related to the potential for change rather than the health need; factors limiting potential for change may include government commitment, priority for health care, political stability, economic conditions, and societal acceptance. Planning should be flexible and iterative, and should consider recurring costs as well as initial development costs. Initial involvement at the community and village level is essential.
Report on mission to Europe and the Middle East to explore interest and potential support of education and health agencies of proposed program of education and health care, Oct. 6-30, 1976.
Wash., D.C., American Public Health Association, (1976) 22 p. plus appendixesThis consultation was designed to assess interest and potential involvement of international education and health organizations in a conference to be arranged by the World Federation for Medical Education, whose objective would be to bridge the gap between the educational complex and the voluntary and official health agencies which provide primary health care for the rural population. WHO and UNESCO agreed to co-sponsor the conference, and meetings were arranged in Paris with officials of their various sub-agencies. Further conferences in Teheran, Shiraz, Kuwait, and Egypt indicated a high level of interest in the conference topic at regional levels. The conference proposal is included as an appendix to this report. In addition, discussions with WHO officials were held concerning the status and planning for 2 bi-regional seminars on "The Physician and Population Change."
Bulletin of the Medical Library Association. 1978 Jul; 66(3):290-295.Following a 1969/70 survey of 114 medical libraries in Burma, India, Indonesia, Mongolia, Sri Lanka and Thailand, the WHO Regional Office for Southeast Asia helped upgrade library service with several programs; establishment of "student loan libraries," provision of free MEDLARS/MEDLINE bibliographies and photocopies of articles, coordination of the International Exchange of Duplicate Medical Literature (IEDML) and funding of fellowships for continuing education for medical librarians. A follow-up survey was conducted in 1975/76 covering 267 health sciences libraries in Bangladesh and Nepal in addition to the previously-surveyed countries. 69% of the libraries responded to the questionnaire which asked about their clientele, budget, personnel, collections and services offered. Results are tabulated by country. There was an increase in the number of trained librarians although few attend professional meetings or refresher courses. Collections are relatively small because of the high cost of health science publications. The production of paperback editions of textbooks by the English Language Book Society and the Indo-American Textbook Programme are alleviating this problem somewhat. However, the availibity of periodicals and indexing and abstracting journals has deteriorated and there exists no indexing periodical for general medical literature originating in developing countries, although abstracting of material on population and family planning has begun. More library services such as acquisitions lists, literature-searching and photocopying are now provided, but the percentages are still small. Lending to students has greatly increased. About 1/3 of the libraries are aware of WHO MEDLARS/MEDLINE services and 1/6 of IEDML. The most important suggestions made for improvement included the establishment of more "student loan libraries," provision of reference services and photocopies at nominal cost, creation of an index to health sciences literature published in Southeast Asia, publication of more low-priced textbooks and more continuing education opportunities for librarians.
In: Connor E, Mullan F, ed. Community oriented primary care: new directions for health services delivery. Washington, D.C., National Academy Press, 1983. 250-7.Education of doctors for community oriented primary care (COPC) in the Netherlands is described. A basic doctor has 6 years of training and is prepared for further specialty training in general practice (currently only 1 year), clinical specialty (4-6 years), and social medicine (4 years). After high school, a weighted lottery is performed. Out of 6000 interested graduates, 1950 are placed in medical faculties. Only straight A students have a double chance. In 1970, the Dutch government started a new medical faculty that was community oriented and emphasized primary health care. For this, the educational system of this facility had to be different. A problem-oriented system was adopted. In 1974, an integrated innovative curriculum was started. The basic philosophy emphasizes a preference for orienting medical education to primary care. By the 5th and 6th year, students must acquire: 1) practical experience in solving primary care problems; and 2) the ability to recognize unusual problems and develop appropriate referral. During the 1st 4 years the problem-solving process is encountered; the problems must be increasingly complex; and the teaching program progresses from the general to the specific. The teaching program should begin with health problems and proceed to consider normal and abnormal functioning. The original arrangement for hospital internships is not yet feasible. It seems that hospital organization is too rigid to combine with a less department-linked program. Evaluation is mandatory. A theoretical final M.D. exam was designed. The World Health Organization (WHO) held a meeting at which key figures from 18 selected schools were brought together. From this meeting, it was agreed that a network would be developed linking schools. The network members met again and formulated objectives.